go back

Minnesota rates for HCPCS 67221

Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $281.84 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,778.28 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $524.81 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,000.00 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $707.95 / $1,202.26
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $954.99 / $1,905.46
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $676.08 / $1,122.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $426.58 / $812.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $537.03 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,137.96 / $4,265.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $436.52 / $870.96